Wet Age-Related Macular Degeneration

Wet ARMD is a more severe form of ARMD characterized by abnormal blood vessel growth in the choroid layer, called choroidal neovascularization (CNV).

The new blood vessels are abnormal and tend to leak fluid or blood, causing macular swelling, and further distortion of central vision.

Vision loss with wet ARMD progresses much faster than vision loss with dry ARMD.

Dry ARMD can turn into wet ARMD at any time.

Current treatments for ARMD include nutritional supplements via antioxidant vitamins plus zinc (AREDS formula), anti–VEGF injections (Lucentis and Avastin), and photodynamic therapy (PDT) with Verteporfin (Visudyne).

Vitamins with AREDS formulation – taking vitamins with high levels of antioxidants and zinc can slow or even stop the progression of ARMD. The vitamins can also be used to reduce the risk of developing ARMD.

Dosage of the AREDS formulation:

• 500mg of vitamin C
• 400 international units of vitamin E
• 15mg of beta-carotene (25,000 international units of vitamin A)
• 80mg of zinc (zinc oxide)
• 2mg of copper (cupric oxide)

PDT with Visudyne is a procedure that uses a laser to close the new abnormal blood vessels that grow under the retina. During this procedure, Visudyne is administered intravenously. The Visudyne then concentrates in regions of choroidal neovascularization (CNV), and is subsequently activated with a low intensity non-thermal laser to close the abnormal blood vessels, which are commonly found in CNV.

Lucentis injections and Avastin injections involve anti-VEGF injections that prevent growth of the abnormal blood vessels and fluid leakage common in wet ARMD. Vascular endothelial growth factor (VEGF) is a signal protein that promotes the growth of new blood vessels (angiogenesis). Lucentis and Avastin suppress cellular production of VEGF, thus inhibiting new blood vessel growth/CNV.

Centrasight mini telescopic implant – A mini telescope is implanted in end stage ARMD patients. The implant is able to magnify an image onto healthy retinal tissue, thus restoring central vision in patients suffering from advanced ARMD. The mini telescope is implanted in only one eye. The operated eye becomes dominant and is used for central vision, and the un-operated eye is used for peripheral vision. The tiny telescope has been FDA approved since 2010. This procedure will soon become available at Terry & Alsheikh eye Associates with Dr. Oday Alsheikh.